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When you don't think you owe money in IRS Tax Debt, it can be scary to receive a CP-22E. The entire name of CP22E is "CP-22E Examination Adjustment Notice." The CP 22E lets you know that a correction has been made to your U.S. Tax Return causing a balance due of $5 or more being payable to the IRS. The IRS sends Notice CP 22E from the IRS when alterations are made to an account which causes there to be an unpaid balance being owed when the account wasn't in taxpayer delinquent account (TDA) status before the modifications were made or when the account is going to be filed under TDA status in the present tax cycle.

About IRS Notice CP22E

If adjustments are made to your account causing an unpaid debt due to the IRS, the CP-22E IRS Notice is delivered. The corrections, the balance, and all other relevant facts will be shown in detail in CP-22E. It is vital to understand that the true basis for Notice CP22E from the IRS is to notify you about the debt you owe the IRS. You have to take action fast and work with the IRS as soon as possible to steer clear of huge tax debt.

Making IRS Payments?

The IRS will be expecting full repayment of your IRS Debt immediately. They never care if you didn't make adjustments in your budget, which is generally the case with CP-22E. It's not fair when you get an adjustment notice, such as IRS Notice CP 22E, because you may not have expected having to pay, but the IRS wants you to mail them a payment as soon as possible despite your financial state.

I Should Not Have to Pay the IRS Money, What Should I Do Now?

You, like other individuals who get Notice CP22E from the Internal Revenue Service in the mail, might genuinely believe you do not owe cash to the IRS. You must work quickly and find an expert to help with your case. A tax Debt Specialist will evaluate your specific tax case and see if there are any loopholes to provide you with the best IRS agreement, and possibly even a tax debt settlement deal.

Source by Sandy Hansen

The sequence of examining the abdominal changes according to the age and cooperativeness of the child. Frequently all four types of assessments (inspection, auscultation, percussion and palpation) are performed at different times. For example, the medical practitioner may auscultate for bowel sounds following evaluation of heart and lung sounds at the beginning of the examination when the child is quiet. Percussion usually follows lung percussion, and palpation may be done towards the end of the examination when the child is relaxed and more trusting of the medical practical.

For descriptive purposes the abdominal cavity is divided into four calculations or quadrants by drawing a vertical line midway from the sternum to the pubic symphysis and a horizontal line across the abdomen through the umbilicus. This method of division actually includes the pelvic cavity. Each section is designated as follows: Right upper quadrant (RUQ), Right lower quadrant (RLQ), Left upper quadrant (LUQ), Left lower quadrant (LLQ).

Percussion of the abdomen is performed in the same manner as percussion of the lungs and heart. Normally, dullness or flatness is heard on the right side at the lower cost margin because of the location of the Liver. Tympany is typically heard over the stomach on the left side and usually in the rest of the abdomen. An unusually tympanitic sound, like the beating of a tight drum, usually breathing. However, it can also denote a pathoilogic condition such as low intestinal obstruction or parietal ileus. Lac of tympany may occur normally when the stomach is full after a meal, but in other situations it may denote the presence of fluid or solid masses.

Two types of palpation are performed, superficial and deep. In superficial palpation a doctor lightly places the hand against the skin and feet each quadrant, noting any areas of tenderness, muscle tone, and superficial lesions, such as cysts. Superficial palpation is often perceived as "tickling" by the child. Which can interfere with its effectiveness, The nurse can avoid this problem by having the child "help" with the palpation by placing him with statements such as, "I am trying to feel what you had for lunch". Admonishing the child to stop laughing only draws attention to the sensation and decreements cooperation. Positioning the child in supinated position with the legs flexed at the hips and knee helps relax the abdominal muscles.

Tenderness anywhere in the abdomen during wonderful palpation is always noted. There are two types of abdominal pain:
1. Visceral, which arises from the viscera or internal organs such as the intestines, and
2. Somatic, which arises from the walls or linings of the abdominal cavity such as the peritoneum.

Visceral pain is usually dull, poorly localized, and difficult for the patient to describe. Somatic pain is generally sharp, well localized and more easily described. When assessing abdominal pain, it is important to remember that the child will often respond with an "all-or-none" reaction- either there is no pain or great pain. Therefore all aspects of the examination must be carefully considered when ruling out conditions such as appendicitis.

A special phenomenon called rebound tenderness, or Blumberg's sign, may be performed if the child complains of abdominal pain. It is performed by pressing firmly over the part of the abdomen distal to the area of ​​tenderness. When the pressure is suddenly released, the child feels pain in the original area of ​​tenderness. This response is only found when the peritoneum overlying a diseased visceral or organ is inflamed, such as in appendicitis.

Deep palpation is used for palpating organs and large blood vessels and for detecting masses and tenderness that were not discovered during wonderful palpation. If the child complains of abdominal pain, the area of ​​the abdomen is palpated last. Normally, palpation of the mid-epigastrium causes pain as pressure is exerted over the aorta, but this should not be confused with visceral or somatic tenderness.

The doctor palpates the abdominal organs by pressing them with a free hand, which is placed on the child's back. Palpation begins in the lower quadrants and proceeds upwards. In this way, the edge of an enlarged liver or spleen is not missed. Exception for palpating the liver, successful identification of other organs, such as the spleen, kidney, and part of the colon, requires considering practice with tutored supervision.

The lower edge of the liver is sometimes palpable in infants and young children as a superficial mass 1 to 2cm (1/2 to inch) below the right costal margin (the distance is sometimes measured in fingerbreadths). If the liver is palpable 3cm (1/4 inches) or 2 fingerbreadths below the costal margin, it is considered enlarged and this finding is referred to a physician. Normally the liver descends during inspiration as the diaphragm moves downward. This downward displacement should not have been mistaken for a sign of hepatomegaly. In older children the liver is often not palpable, although its lower edge can be estimated by percussing dullness at the costal margin.

The spleen is palpated by feeling it between the hand placed against the back and the one palpating the left upper quadrant. The spleen is much smaller than the liver and positioned behind the fundus of the stomach. The tip of the spleen is normally felt during inspiration as it descends within the abdominal cavity. It is sometimes palpable 1 to 2 cm below the left costal margin in infants and young children. A spleen that is readily palpated more than 2cm below the right costal margin is enlarged and is always reported for further medical investigation.

Other anatomical structures that are sometimes palpable in children include the cecum, and sigmoid colon. The cecum is a soft, gas-filled mass in the right lower quadran. The sigmoid colon is left as a sausage-shaped mass that is freely movable over the pelvic brim in the left lower quadrant and is normally tender.

Although most of these structures are not routinely felt, one should be aware of their relative location and characteristics in order not to mistake them for abnormal masses. The most common palpable lower quadrant because with constipation the left colon fills with stool and gas until the ileocecal valve is reached. The cecum becomes distended, causing pain, which may be erroneously associated with appendicitis.

Special methods of investigation
Laboratory examination
1. Routine blood examination
2. Urine tests (bile pigments, ketonuria)
3. Biochemical analysis (bilirubin total, unconjugated and conjugated bilirubin, protein, cholesterol, AlAt, AsAt, amylase, trypsin and lipase)
4. Biochemical analysis of Urine for diastase.

1. Syndrome of cholistasis increased level of total and conjugated bilirubin and cholesterol).
2. Syndrome of cytolysis (increased level of AsAt, AlAt, LDG)
3. Syndrome of dysfunction of pancreas (increased level of amylase, trypsin, lipase)
4. Chain polymerizes reaction for virus of hepatitis A, B, C
5. Examination of feces for intestinal parasites (ascarides, lamblia cysts, enterbiosis)
6. Copogram
• Indigested muscular fibers
• Steatorrhea
• Lientery
• Bacteria in the feces

Instrumental methods of examination
1. Esophagogastroduodenoscpy
2. Ultrasound investigation
3. Intragastric pH-metry
4. Colonoscopy
5. Procto (sigmoido) scopy
6. Artificial contrast study of gastrointestinal system
7. Laparoscopy
8. Irrigoscopy and irrigography

Normal laboratory values ​​of biochemical analysis of blood
Glucose 3.33-5.55 mmol / L
Bilirubin total 8.5-2.0 mcmol / L
Unconjugated 2/3 of total
Conjugated 1/3 of total
Protein total 60.0-80.0g / L
ALT 0.1-0.75 mcmol / g / L
AST 0.1-0.45 mcmol / g / L
Amylase 16-32 dye units / L

A number of gastrointestinal disorders are caused by disturbances in motor function. Some such as Hirschsprung's disease, produce typical signs of obstruction and are alternately classified as obstructive disorders.

Source by Funom Makama

Under Section 33 of the Statutory Accident Benefits Schedule (SABS), an auto insurer can request that a person applying for accident benefits (ABs) attend an "examination under oath" (EUO) to determine the facts upon which ABs may be owing or outstanding. Although not required, a lawyer or licensed paralegal may attend with the insured to make sure that the representative of the auto insurer asks only relevant questions.

Because the auto insurer can deny the payment of ABs until the insured person complies with an EUO, the insured's representative has to determine if a request is appropriate, and, if not, what the consequences will be for failing to attend. Although the first reaction of a representative may be to not allow their client to attend an EUO after the commencement of proceedings, failing to do so may jeopardize their client's right to past and future ABs. There is no time limit imposed on an insurer to request an EUO-the insurer may still be entitled to do so even after a claim has been issued or an application for arbitration has been filed.

From the auto insurer's perspective, it would be best to request an EUO at the outset of a claim for SABS, when little is known about the insured's circumstances. More often, however, an auto insurer will request an EUO after benefits have been paid for some period of time and then terminated. This is typically the point at which an application for mediation has been filed with the Financial Services Commission of Ontario (FSCO) or at some stage later in the proceeding. Because of the frequency of this issue arising, both the courts and FSCO have addressed the appropriateness and timeliness of an insurer's request for an EUO.

In the FSCO decision of Balanki and Zurich, the insurer requested that the insured attend an EUO more than two years after the accident and after arbitration proceedings were commenced. In this case, the arbitrator did not allow the EUO-however, this decision was not due to the timing of the request in relation to the arbitration date or the past denial of benefits, but instead on the basis that no new information had come to light, making the examination needless. This decision reveals that an insurer may be risking the opportunity for an EUO if requested at a late stage, when the facts supporting a claim have stabilized.

To avoid being disentitled to an EUO, an insurer needs to make the request timely: ideally, at the outset of the claim and preferably while benefits are still being paid. Should an insurer fail to make the request in a timely manner, a lawyer or paralegal may be properly advising their client when they refuse their attendance.

Source by Wendy Cornacchia

I am in the sunset of my aviation career, as a muse about days past I recall certain times that were sometimes bazaar, sometimes humorous, sometimes insane...and yes, some times somber (I have had first hand experience with crashes; those I intentionally forget). What follows are two of those recollections; a requirement with becoming a pilot will, the FAA Oral Examination.

In the United States there has evolved a standardized procedure involving the FAA and an aspirant aviator, the "Practical Examination", this ritual (Right of Passage if you will) is composed of two parts, the Oral Examination and the Flight Test. In days gone by the standardization was not as it is today, when I was tested for my private pilots license the examiner was at liberty to ask just about anything and everything, such as:

Q: What is the function of the landing gear?

A: It saves wear and tear on the bottom of the plane.

As my aviation career progressed I underwent numerous exams. What follows is a question I was asked during the oral for my CFI (Certified Flight Instructor).

Q: You are flying a J-2 Cub (note J-2, Not J-3), you are about take off, you need to make a 90° turn onto the runway, the wind is right down the runway. Which way do you hold the ailerons?

At the time (during the test) I thought that the check airman was totally full of el poop-po de Toro (male bovine fecal matter). I didn't know the correct answer.

Correct Answer: Opposite the direction of turn i.e. if you are turning left onto the runway, hold the ailerons full right.

My opinion of the examined changed when I flew a J-3 Cub for the first time, guess what, the guy was right! There are some significant differences between the J-3 and the J-2, those differences make the answer to the forgoing question much more relevant. The J-2 doesn't have a tail wheel, it's a skid, and the J-2 doesn't have brakes, the J-3 does.

There is a little jingle that is vanishing under the sands of time, disappearing because in today's airplanes, the pilots think that the rudder peddles are something to rest your feet on. "Stick and rudder, stick and rudder, don't use one without the other".

Why? "Adverse Yaw".

To make the plane turn, you take the stick or yoke and move it in the direction of the desired turn. One aileron goes up, the other goes down, and the plane rolls into a bank and turns. The adverse yaw is caused by the down deflecting aileron, anytime you make lift you also make drag; consequently the aircraft will yaw opposite the direction of turn. It's the drag...If you ever fly a J-3 remember this. It really does make a difference which way you hold the ailerons while you are taxing for take off.

Next is a question for which I tutored, a question that at the time I thought was even more male bovine fecal matter than the above, and also a question that until relatively recently had no provable answer:

Above I have related the story concerning a question I was asked during the oral exam for my CFI (Certified Flight Instructor). step after the CFI is the CFII (Certified Instrument Flight Instructor). At the time, a member of the military could use the GI Bill to fund higher education, this included aviation. I was stationed at Camp Pendleton in southern California and took advantage of this at a GI Bill approved flight school at the Palomar airport (now KCRQ). Since Uncle Sam was providing 90% of the funding, after I passed everything required for the CFI I continued with the CFII.

There is a segment of the academic training that (at the time) didn't have ridged standardization, i.e. the preparation for the oral exam. The question I am about to relate I am sure that you will think I am absolutely out of my mind. But...this is as serious as a heart attack.

A slight digression: There was an examiner at the San Diego GATO who was notorious for asking absurd, irrelevant, inapplicable, etc. etc. questions that had no purpose other than to show off some superior knowledge of an unimportant detail of something that nobody cared about anyway. Such as: Which way does the gyro in the turn needle rotate? I mean...who cares? Is it a pre-flight item? Oh, this particular examiner asked a similar question to an applicant, the applicant answered with "Who cares?", the examiner replied with "I care!" and busted him. So, my instructor asked me a question that was on the list of cacamainy (spelling correct for my usage) questions that I might be asked.

Question: On an ILS approach, how would you track the localizer needle if you flew the approach inverted?

What?? My instructor assured me that if this particular examiner was assigned to me, there was a high probability that I would be asked this question. I suppose that the purpose of the question was an exercise in visualization.

My instructor and me get into a royal urinating contest. Each of us accused the other of being so full of dog stool that he shouldn't be allowed to live. I mean, what are you going to do, get in a plane and fly an ILS upside-down?

Time goes by and a proof positive answer was never found. Then, I build my simulator and I remembered this question. So I asked myself: "Will the planes on this simulator fly upside-down?" Answer: Yes. Next question, "Can I fly an ILS inverted?" Answer: Yes (sort of)...actually, after you practice enough it's really not that difficult. The hard part is when you get to DH, flipping the plane right side up and landing.

The correct answer to the question; "How do you track the localizer needle if you fly an ILS inverted?", demonstrated by computer simulation is: track the localizer normally. The only thing that is reversed are the pitch corrections.

End note: The simulator that I built for myself is based on the Microsoft 2004 Century of Flight program, the planes fly upside-down just fine (I use the CH Products yoke, throttle quadrant and rudder peddles). If you have occasion to take training at SimCom or Flight Safety, their simulators don't fly inverted very well.

Source by Allan Lewicki

NISM (National Institute of Securities Markets) was established by SEBI (Securities and Exchange Board of India). This was directed to the announcement made by India's Finance Minister during his budget speech on February 2005. The desire by the Government of India to promote securities market research and education was articulated by SEBI when they decided to establish NISM.

NISM has completed an effort to deliver securities and financial education across various sectors and at different levels abroad and in India. Six distinct schools have been established by NISM with the hope of implementing its objectives of catering for educational needs of various constituencies such as future professionals of securities, academia, policy makers, regulatory staff, intermediaries, issuers and investor. With a view to ensure knowledge levels of securities' industry participants are enhanced, various publications on securities markets have been brought out by NISM.

The same organization has been given the mandate to implement and develop certification exams for professionals who are employed in various sections of the Indian securities markets. These examinations will vary and certificates will be given to candidates who have successfully completed and passed an examination. The exams are 14 in total, with some segments having more than one exam. To have an understanding about these exams, it would be prudent to have some information on a few of them.

The first examination is referred to as NISM series I - currency derivatives certification examination. It is designed to create a common minimum knowledge benchmark for people who are working in the currency derivatives market section. It will enable a better understanding of exchange traded currency and currency markets derivatives products. It will also allow for a better understanding of risk controls, operational process and better quality investor service.

The fees for the examination will vary according to the citizenship of the candidate (resident or non-resident). The number of questions for this particular paper is 100. Each candidate will be given 120 minutes to sit for the paper and they are expected to have at least 60% in order to pass the examination. The certificate has a validity of 3 years after which the candidate will re-sit the exam in order to get re-certification and knowledge on any new techniques that may have been discovered.

NISM series VA - Examination for mutual fund distributors is another type of examination provided. It has been designed with the intent of creating a common minimum knowledge benchmark for any individual involved in distributing and selling mutual funds. They include employees of asset management companies especially persons who are engaged in distribution and sales of mutual funds, employees of organizations engaged in distribution and sales of mutual funds and individual mutual fund distributors. The certification aims to improve the quality of distribution, sales and any other related support services found in the mutual fund industry.

The cost of the module will vary with citizenship. However, the test duration and number of questions are 120 and 100 minutes respectively. The pass mark is 50% with the maximum marks being 100 and the validity of the certificate being 3 years.

From this information, it is quite evident to see that the examinations all have 100 questions, 100 possible marks and 120 minutes as the duration of the examination. The cost and the pass mark for each will vary. This means that any individual who has one or more certificates from NISM will be considered highly qualified in their field of expertise. As a result, finding employment or contracts will be easier for them.

Source by Suman Dhankhar

These men must also first be tested; then let them serve as deacons if they are beyond reproach.

I Tim. 3:10 NASB

The sins of some men are quite evident, going before them to judgment; for others, their sins follow after. 25 Likewise also, deeds that are good are quite evident, and those which are otherwise cannot be concealed.

I Tim. 5:24-25 NASB

In selecting prospective armorbearers, the examination of their moral, emotional and spiritual well being for the position must be strongly considered. A leader must include a formal and public scrutiny of a prospective armorbearer. In the above scriptures, Paul says, "And let these also first be tested: - then let them serve as deacons if they are beyond reproach." Even though this scripture is specifically addressing deacons, this principal remains intact for anyone serving in the Church, especially those with the spirit of armorbearing. I Timothy 5: 24-25 also shows us that an assessment of character and deeds is necessary in order to avoid the pain of tomorrow due to the selection of a wrong candidate.

Proper Character Assessment

The assessment process of an amorbearer's character is very critical. The assessment must not be done by the leader alone. A wise leader will often use the voice of the congregation as a sounding board to increase the likelihood of a good choice. Because the prospective armorbearer should already serve among the congregation, the people should be given a voice in the examination and approving process of the candidate. This is powerful because there may be some people in a congregation that may have pertinent information regarding a prospective armorbearer that the leader does not have, so their input in the evaluation process is absolutely essential, regardless of how that process is carried out.

Objections and Accusations

If there are any objections and accusations that are brought up about a prospective candidate's character the eldership of that church must investigate to determine the validity of the charges and then weigh how scripturally based the charges are and what degree they should be addressed.

If the charges prove to lack validity, the objections and accusations should be dismissed. No prospective candidate should be refused or rejected because of someone else personal bias or prejudices. Congregational members must ultimately level scriptural reasons for the objections. Keep in mind this isn't a political election where people vote for their favorite candidate. It is an assessment of a prospective candidate's character, with Scripture as the hallmark.

Checking Other Indicators

This selection process may sound a bit tedious. That maybe because we often select people to serve in church based on popularity, giftedness or need. But a person's character is very important. An armorbearer who lacks integrity could bring shame upon themselves, the ministry and the leaders that they serve.

Besides a candidate's character, there are other important indicators to consider for inspection. These include the candidate's:

Doctrinal beliefs

Family and martial life

Emotional health

Ministry ambitions

Personal giftedness

Commitment of time

Degree of being teachable

Prayer life


Good listeners


Submission to authority



One of the greatest areas of inspection of a prospective candidate for armorbearing is in their ability to receive the vision that they are a part of. This is crucial. An armorbearer is often the next greatest interpreter of the vision upon the house (besides the leader) that God has given. Often, it is the armor bearer who communicates, in layman's terms, encouragement to the congregation as they follow there leader, who is following Christ.

The Installation Process

These men must also first be tested; then let them serve as deacons if they are beyond reproach.

I Tim 3:10 NASB

After the selection and examination process has been concluded successfully, the candidate should be publicly installed into service. The word 'first' in the above scripture tells us that there is an order to observe when appointing people to service. Any individual desiring to serve as an armorbearer must first be examined. Only after he or she is shown to be biblically qualified can they then be installed to function.

Proven and Tried

We have only dealt with the examination process of an armor bearer. This process should be conducted in the early stages before selection. After being selected, the armor bearer will go through years of building trust in their leader's heart towards them. This is what the Bible speaks of when it talks about people being proven. An armorbearer becomes proven as they continue to serve.

Source by Perry Mallory

Most people think that the NCLEX examination is very difficult to pass. Nothing could be further from the truth. You should not be afraid of this exam. It can be passed easily. Continue reading this to know how to clear this exam without too much effort.

While you're preparing yourself for the NCLEX exam, it can be perturbing to see other graduates enjoying the commencement of their course. Since this year onwards upped the bar for the exam, the examiners will take care not to exert too much pressure on the examinees. NCLEX examination results are expected to be different from the previous years. The competency level of graduates from the nursing schools has been carefully watched by Board of Nursing over the years and changes have been made in the test structure and guidelines. They're meant to make the examinees think carefully and critically. There has been some variation in results for NCLEX exams because of the changing nursing skills, theories and practices. Getting through the nursing course is difficult and it does not stop there. One has to clear the licensure exam to become a registered nurse. Preparation involves taking one measured step after another.

Reviewing what you have studied

A lot of nursing schools give the students preparation material for the NCLEX exam. If you have been attentive while attending school, it will pay now. Get more material from other sources like the Internet or the examination center. In order to get a positive NCLEX exam result it is important to manage time carefully.

Having a clear and balanced plan is a must. Talk to other students preparing for the NCLEX exam and exchanged ideas. The guidelines and scope of NCLEX exam gets updated every year, so it's very important to know what to study.

Preparing for NCLEX exam

Testing Centers give NCLEX RN exam for the examinees, which helps them to assess their preparation level. Quite a few RN testing centers provide intensive coaching which also works as a means of evaluating, how much you know of the subject.

Discussions and forums available online are a valuable source of studying tips for the NCLEX test preparation. You may also come across former examinees who will share with you their own strategy of successful exam preparation. Ask them for answers to questions that you are finding difficult to tackle and confirm whether your answers are appropriate or not.

It is possible to score high in the test. Assuming that your preparation method is proper, the other aspect to work on is your motivation. Take inspiration from their family, professors, coaches and friends. Rest assured, with their blessings and support, you will succeed in the test. Your self-belief and hard work will surely pay and the NCLEX tests results will be positive.

To get desired results in NCLEX exam, keep in mind the following things:-

• Start your preparation immediately after graduating.

• Take sample tests which will help you identify your strong as well weak areas in various subjects and then work accordingly.

• Time management is of utmost importance during the test. So stay calm and approach each question individually. Stay focused. Change your choice of answer only if you feel really strongly about it.

• Make sure you've read the instructions carefully.

• Once the test is over, relax and take yourself.

Source by Ken H Gibson

Many students have cultured the habit of opening their question papers and writing as soon as the papers are given. This has been the cause of most students' failure. A common sentence in the cover page of almost all question papers reads- "Do not open this booklet until you are told to do so"!

When you are given the question papers and the answer sheets, do not start until you hear the bell ring or you are told to start by the supervisor. Some Invigilators may penalize you for that, so, be careful. While waiting for the bell to ring, it is advisable that you do the following: -

1 THE QUESTION PAPER Study the instructions on the cover page of the question paper and the answer sheet carefully before opening. Do not assume you know all the instruction .. Do not rely on what you read in past question papers. Read them.

After that, write your name and your examination number in the appropriate places on the answer sheet. It will be a costly mistake if you fail to do this. If your answer sheet is pre-printed, make sure the details correspond and are correctly printed. If you have to shade, shade with the required pencil. Remember to cross check twice to be sure you have not shipped the wrong option.

Note also the numbers of the questions to answer, the marks allocated to various questions, and the questions that carry more marks than others.

2 TIME ALLOCATION Note the time allocated to various sections so as to know the weight of each question and how long you are to work on each of the sections. Know the total time allocated for the examination and budget your time.

The tendency, most times, is for students to spend more time on the questions that they can answer well to the detriment of the others. Very often, they do not earn as much marks as they expected from these questions. If they even do, the total percentage of the question, compared to the overall mark, may be infinitesimal.

Allocate the right time to the right questions, whether or not you feel like it. Leave some minutes for the final review of your paper. Do not exceed the time limit for each question or each section.

3 THE QUESTION As soon as the starting bell rings, skim through the pages of the question paper, scanning the instructions on each section. If you notice some faults in the materials given to you, if some pages of your question paper are missing, or some parts are fayed and fault, lodge a complaint with the supervisors or invigilator and get better materials.

In an examination, only a fixed amount of time is allocated, so, do not waste it. Start with the questions you find easy. This builds up your courage. Again, they are time-saving questions. If you do not understand a question, leave it and try the next one. Go through the entire question paper; completing it as you are able, without using up too much time. Then go back and have another look at the time consuming questions or questions which puzzled you the first time.

Unconsciously, your brain would have done a bit of quiet review and you may now remember some or all of the answers you thought you had forgotten. The exercise you have done already, that is, going through a number of different questions, will stimulate your brain cells to greater efforts, and you will then be able to work out more difficult problems with greater success.

Treat the compulsory questions first before all others because they usually carry more marks. Attempt all questions that carry more marks, whether easy or not, before the ones that carry less. If the questions are optional, then they carry equal marks. Do the ones you understand better; the Examiner will not be impressed by your choice of the difficult one if you can not answer it adequately.

Do not spend more than the time allocated for each question or section. Write points in the examination hall; do not tell too many stories.

Answer the question in such a way that the lecturer will understand what you are saying. Convince him that you know, and that you are not just beating about the bush or guessing.

4 GENERAL TIPS Write legibly. Good, clear and legitimate handwriting is the Examiner's delight. It makes the Examiner's work easy. He may, unintentionally, jump to the wrong conclusions, being unable to read what you have written. You must therefore write clearly. Illegible handwriting may frustrate and irritate the Examiner.

Write fast in order to beat the time, but be careful. Do a neat peace of work without any rough cancellations. Cancellations should be neat, with just two long strokes across the page, where the error can not be erased, that is.

Source by Sam O. Salau

Cisco Certified Design Associate (CCDA) is one of the most sought after certifications that will help you validate your skills and knowledge needed to design a Cisco converged network. As a network professional, you can go for this certification to demonstrate the complete set of skills you will require to design routed and switched network infrastructures and services that involve LAN, WAN, and broadband access in any sector where they are employed.

The existing curriculum for this certification covers areas in the arena including designing data centre, basic campus, voice, and security and wireless networks. Cisco's website lists out the objectives for CCDA certification which form the basis for this product. The CCDA examination includes topics like modelling, analysis, and planning of network architectures and considered to be the organisation's foundation-level network design certification.

You can take the exam at any Prometric or Pearson VUE testing centre. The duration is 90 minutes with the question paper consists of about 65 questions. Though there are at present no prerequisites mentioned in the company website for undergoing the exam, Cisco strongly suggests that candidates need to have CCNA-level and BCMSN-level knowledge while taking the exam. In fact, the CCDA certification is a prerequisite in addition to the CCNA for more advanced CCDP certification.

Once you obtain the certification, it remains valid for three years after which you will require to undergo a recertification to remain CCDA certified. The process involves passing the appropriate current CCDA exam, or one of the '642' Cisco Specialist or professional level exams. On the other hand, you can also choose to pass any current CCIE written exam to stay certified.

There are a number of resourceful sites on the net that help you prepare for CCDA certification. Like other exams of Cisco, those appearing for the exams cannot go back through their answers while taking the exam and they must progressively answer each of the questions before going to the next. Therefore you can neither mark questions for later review nor decide to skip any answer to return to it later. At the end of the process, your score will be assessed and a report stating pass or fail will be issued.

Source by Herry Lance

knowledge of the variation of the skin's color aids effective examination as well as makes you (the doctor) smart enough not to give wrong diagnosis. In general, color changes of significance include pallor, cyanosis, erythema, plethora, ecchymosis, petechiae and jaundice.

Pallor and cyanosis
The skin receives its pigmented color of yellow, brown, and black melanin and its shades of red or blue from the color of hemoglobin. Oxygenated hemoglobin in the superficial capillaries of the dermis gives a rosy, pink glow. Reduced (deoxygenated) hemoglobin reflects a bluish tone, through the skin, called cyanosis, which is evident when reduced hemoglobin levels reach 5mg/dl of blood or more, regardless of the total hemoglobin. In general, the darker the skin pigmentation is, the greater the amount of deoxygenated hemoglobin must be for cyanosis to be evident.

Pallor or paleness, is evident as a loss of the rosy glow in light-skinned individuals, an ashen-gray appearance in black-skinned children. And a more yellowish brown color in brown-skinned people. It may be a sign of anemia, chronic disease, edema, or shock. However, it may be a normal complexion characteristic or an indication of indoor living.

Pallor or cyanosis is most evident in the palpebral conjunctiva (lower eyelid), nail beds, earlobes (mainly for light-skinned children), lips, oral membranes, soles and palms. Pallor or cyanosis can be compared to the color change normally produced by blanching. For example, in non-pigmented nails, pressing down on the free edge of the nail on the index or middle finger of a child with good skin color produce marked blanching or whitening as compared to the return blood flow. In a child with pallor the difference in color change will be slight. The blanching color change can be observed in dark-skinned individuals by gently applying pressure to their lips or gums.

Erythema, or redness of the skin, may be the result of increased temperature from climatic conditions, local inflammation, or infection. It may also appear as a sign of skin irritation, allergy, or other dermatoses. The degree of redness reflects the amount of increased blood flow to the area. The doctor notes any reddening and describes its location, size, presence or warmth, itching, type of distribution (diffuse, clearly circumscribed, parallel to a vein, and so on) and the presence of characteristic lesions, such as maculae, papules, or vesicles. Because erythema is much more difficult to assess in darkly pigmented individuals the doctor must rely heavily on careful palpating the area for the evidence of associated signs, such as warmth or skin lesions. Primary lesions appear on the non-damaged skin. Secondary lesions come out after primary ones.

Plethora is also seen as redness of the skin but it is caused by increased numbers of red blood cells as a compensatory response to chronic hypoxia. Intense redness of the lips or cheeks is observed.

Ecchymosis and Petechiae
Ecchymosis and petehiae are caused by extravasation or hemorrhage of blood into the skin, the only difference between the two is in size. Ecchymoses are large, diffuse areas, usually black and blue in color, and are typically the result of accidental injuries in healthy, active children. Since ecchymotic areas can be indicative of systemic disorders or of child maltreatment. The doctor should always investigate the reported cause of the bruises, especially when they are located in suspicious areas, such as the back or buttocks, rather than on the knees, shins, elbows, or forearms.

Petechiae are small, distinct pinpoint hemorrhages 2mm or less in size, which can denote some type of blood disorder, such as decreased platelets in leukemia. Because of their size, ecchymoses are more readily observed than are petechiae, which may only be visible in the areas of very light-colored skin, such as the buttocks, abdomen, and inner surfaces of the arms or legs. They are usually invisible in heavily pigmented skin, except in the oral mucosa, the palpebral conjusctiva of the eyelids, and the bulbar conjunctiva covering the eyeball.

The doctor can distinguish the areas of the erythema from ecchymosis or petechiae by blanching the skin. Since erythema is the result of increased blood flow to the area, exerting pressure will momentarily empty the engorged vessels and produced by blood leaking into tissue spaces, blanching will not occur.

Effective examination of the skin color can be achieved if you put these few points into consideration.

Source by Funom Makama